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There is some evidence that male gender could have a negative impact on the prognosis and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The aim of the present study was to compare the characteristics of coronavirus disease 2019 (COVID-19) between hospitalized men and women with confirmed SARS-CoV-2 infection. This multicenter, retrospective, observational study is based on the SEMI-COVID-19 Registry. We analyzed the differences between men and women for a wide variety of demographic, clinical, and treatment variables, and the sex distribution of the reported COVID-19 deaths, as well as intensive care unit (ICU) admission by age subgroups. This work analyzed 12,063 patients (56.8% men). The women in our study were older than the men, on average (67.9 vs. 65.7 years; p < 001). Bilateral condensation was more frequent among men than women (31.8% vs. 29.9%; p = 0.007). The men needed non-invasive and invasive mechanical ventilation more frequently (5.6% vs. 3.6%, p < 0.001, and 7.9% vs. 4.8%, p < 0.001, respectively). The most prevalent complication was acute respiratory distress syndrome, with severe cases in 19.9% of men (p < 0.001). In men, intensive care unit admission was more frequent (10% vs. 6.1%; p < 0.001) and the mortality rate was higher (23.1% vs. 18.9%; p < 0.001). Regarding mortality, the differences by gender were statistically significant in the age groups from 55 years to 89 years of age. A multivariate analysis showed that female sex was significantly and independently associated with a lower risk of mortality in our study. Male sex appears to be related to worse progress in COVID-19 patients and is an independent prognostic factor for mortality. In order to fully understand its prognostic impact, other factors associated with sex must be considered.

Background The outbreak of coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), in December 2019 in Wuhan, People's Republic of China, has developed into an unprecedented pandemic with enormous pressure on health-care providers around the world. A higher mortality rate has been described in older infected individuals. Patients with hip fracture are a particularly vulnerable population during this pandemic because older age is associated with a higher mortality rate. Our aim was to describe the early mortality rate and demographic variables in a hip fracture sample population in Spain during the coronavirus pandemic. Methods This is a multicenter, observational, retrospective, descriptive study. We collected data from 13 major hospitals in Spain from the beginning of the national state of alarm (declared on March 14, 2020, by the Spanish government) until the end of our study period on April 4, 2020. All patients who were ≥65 years of age, presented to the Emergency Department of the participating hospitals during this period with a diagnosis of proximal femoral fracture, and had a minimum follow-up of 10 days were included in the cohort. In addition to mortality, demographic and other potential prognostic variables were also collected. Results In this study, 136 patients with a hip fracture were included. Of these patients, 124 underwent a surgical procedure and 12 were managed nonoperatively. The total mortality rate was 9.6%. Sixty-two patients were tested for COVID-19, with 23 patients being positive. The mortality rate for these 23 patients was 30.4% (7 of 23 patients) at a mean follow-up of 14 days. The mortality rate was 10.3% (4 of 39) for patients who had been tested and had a negative result and 2.7% (2 of 74) for patients who had not been tested. Of the 12 patients who were managed nonoperatively, 8 (67%) died, whereas, of the 124 patients who were surgically treated, 5 (4%) died. Results differed among centers. Conclusions There is a higher mortality rate in patients with a hip fracture and an associated positive test for COVID-19. Level of evidence Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

This study aims to provide a method for developing artificial neural networks in estuaries as emulators of process-based models to analyse bathing water quality and its variability over time and space. The methodology forecasts the concentration of faecal indicator organisms, integrating the accuracy and reliability of field measurements, the spatial and temporal resolution of process-based modelling, and the decrease in computational costs by artificial neural networks whilst preserving the accuracy of results. Thus, the overall approach integrates a coupled hydrodynamic-bacteriological model previously calibrated with field data at the bathing sites into a low-order emulator by using artificial neural networks, which are trained by the process-based model outputs. The application of the method to the Eo Estuary, located on the northwestern coast of Spain, demonstrated that artificial neural networks are viable surrogates of highly nonlinear process-based models and highly variable forcings. The results showed that the process-based model and the neural networks conveniently reproduced the measurements of Escherichia coli (E. coli) concentrations, indicating a slightly better fit for the process-based model (R2 = 0.87) than for the neural networks (R2 = 0.83). This application also highlighted that during the model setup of both predictive tools, the computational time of the process-based approach was 0.78 times lower than that of the artificial neural networks (ANNs) approach due to the additional time spent on ANN development. Conversely, the computational costs of forecasting are considerably reduced by the neural networks compared with the process-based model, with a decrease in hours of 25, 600, 3900, and 31633 times for forecasting 1 h, 1 day, 1 month, and 1 bathing season, respectively. Therefore, the longer the forecasting period, the greater the reduction in computational time by artificial neural networks.

[spa] El objetivo principal de la Tesis realizada ha consistido en el conocimiento de la fauna de organismos edáficos y acuáticos preservados como bioinclusiones en ámbar español de los yacimientos albienses de Peñacerrada I y I , San Just y El Soplao, aunque se han tratado secundariamente otros registros extranjeros. El hallazgo de estos grupos es excepcional por su rareza en el registro fósil, y su estudio ha permitido avanzar en el conocimiento de la composición, diversidad y ecología de los paleoecosistemas terrestres del Cretácico Inferior de la Península Ibérica. Así mismo, se ha hecho especial énfasis en el estudio de las piezas de ámbar de hojarasca “litter amber”, con origen en las emisiones de resina que alcanzaron la parte más superficial del suelo del bosque. El estudio sistemático de los artrópodos relacionados con ambientes edáficos y acuáticos preservados en el ámbar de España ha mostrado una gran diversidad, y el primero también una gran disparidad. Para un total de 165 inclusiones de artrópodos catalogadas, se ha determinado un orden de arácnidos (Oribatida con cinco familias identificadas), dos de crustáceos (Tanaidacea con dos familias; e Isopoda con tres familias) y seis de hexápodos (Entomobryomorpha con una familia; Symphypleona con tres; Archaeognatha con dos; Hemiptera con dos, Coleoptera con una; y un Isoptera clasificado en el grado “Meiatermes”). Muchas de las fam lias identificadas cuentan en el ámbar de España con sus rep esentantes más antiguos conocidos. En algunos casos se ha identificado el único representante del Mesozoico y en otros los ejemplares reconocidos son los únicos en todo el registro fósil para sus respectivas familias. A pesar de que el sistema suelo/hojarasca representa un ambiente poco favorable para la fosilización de la biota, y que sus habitantes suelen ser ormas ápteras de hábitos crípticos, la abundancia documentada en el ámbar de España y el análisis tafonómico revelan que exudaciones de resina muy fluidas y copiosas llegaron al suelo del bosque y atraparon organismos diversos y restos de otro tipo que se encontraban en la superficie del suelo. Por ello, las piezas de ámbar de hojarasca constituyen una fuente de información valiosa para comprender estos ecosistemas. Todos los grupos identificados indican un ambiente muy húmedo. Esto es congruente con el escenario propuesto para los bosques cretácicos de gimnospermas de Iberia productores de resina, para los que se ha descrito una vegetación tropical/subtropical y un clima cálido y húmedo. Estos grupos debieron desempeñar un papel importante en el procesado de la materia orgánica en descomposición que se acumulaba en el suelo del bosque. El hallazgo de algunos ejemplares que muestran adaptaciones a la vida acuática (colémbolos, heterópteros y coleópteros) indica que en el bosque húmedo cretácico se desarrollaron diferentes ambientes acuáticos (tanto lóticos: ej. ríos y arroyos; como lénticos: ej. lagunas y charcas) con sus propias biocenosis. Se trata de grupos semiacuáticos que quedaron atrapados en la resina fuera del agua. La paleoetología se ha centrado principalmente en tres cuestiones: evidencias de cuidado parental, evidencias de cortejo, y evidencias de comportamientos de agregación (en dos grupos diferentes). La estabilidad en el tiempo profundo de las condiciones ecológicas generales y de los modos de vida de los organismos que habitaron la hojarasca de los suelos de los bosques explica la estasis morfológica y etológica observada en estos grupos, y también las similitudes entre los organismos estudiados en el ámbar de España y los estudiados en los ámbares cretácicos más antiguos del Líbano y menos antiguos de Francia.

El ambiente obesogénico que se puede definir como la suma de las influencias que los entornos, las oportunidades, o circunstancias de la vida, tienen para promover obesidad en individuos o la sociedad. El objetivo de este trabajo es describir la prevalencia de sobrepeso y obesidad (SP/OB) y su relación con variables del micro-entorno obesogénico en la población de 18-64 años residentes en la ciudad de Elche (España). Para ello se ha realizado un estudio transversal, donde se recogen diversas variables con una muestra piloto de 150 participantes. Se ha calculado la prevalencia de SP/OB y sus correspondientes intervalos de confianza y para medir la relación entre variables se utilizó la prueba Chi-cuadrado. Entre los principales resultados destacan que el 52,0% de la población presenta SP/OB siendo mayor en varones (59,5%); ésta prevalencia se incrementa con la edad. Hay una mayor prevalencia en personas con bajo nivel educativo (60,7%), bajos ingresos (61,1%), y en las personas en desempleo (58,6%). Se observa una mayor prevalencia en las personas que duermen menos de 6 horas (62,5%), en personas sedentarias (66,7%), y en aquellas con bajo nivel de estrés (64,7%). También presentan mayor prevalencia aquellos que frecuentan restaurantes menos veces (58,3%), los que acuden a restaurantes de menú (70,3%) o de comida basura (57,1%), que utilizan máquinas expendedoras (61,9%) y aquellos que comen acompañados (56,5%). Existe una asociación estadísticamente significativa entre el SP/OB con la edad, situación laboral, nivel de estudios, tipo de restauración colectiva de preferencia y comer acompañado. The important role of the environmental and lifestyle factors in the prevalence of overweight and obesity, has been well established and constituting es the obesogenic environment. The aim of this study is to describe the prevalence of overweight and obesity and its relationship with the micro-obesogenic environment variables in the population of 18-64 years from Elche city (Spain). We have designed a cross-sectional study, which includes several variables and the pilot sample was composed of 150 participants. The prevalence of overweight and obesity and its corresponding confidence intervals has been calculated. In order to establish relationships between variables the chi-square test was used. Among the main results, the prevalence of overweight and obesity is was 52,0%, being greater in males (59,5%) and increased with age. According to socioeconomic variables, there is a higher prevalence in people with a low educational level (60,7%) and a low income (61,1%). Also a higher prevalence in people who sleep less than 6 hours (62,5%), in sedentary people (66,7%) and those with low levels of stress (64,7%). Regarding the micro-environment, a higher prevalence of overweight and obesity in people who visit restaurants occasionally (58,3%), those who frequently follow restaurant menues (70,3%) or fast-food restaurants (57,1%), who use vending machines (61,9%) and those who eat accompanied by other people (56,5%). There is a statistically significant association between overweight and obesity with age, work status, level of studies, type of catering preference and eating accompanied by people.

A simplified two-dimensional eutrophication model was developed to simulate temporal and spatial variations of chlorophyll-a in heavily regulated coastal lagoons. This model considers the hydrodynamics of the whole study area, the regulated connexion of the lagoon with the sea, the variability of the input and output nutrient loads, the flux from the sediments to the water column, the phytoplankton growth and mortality kinetics, and the zooplankton grazing. The model was calibrated and validated by applying it to the Albufera of Valencia, a hypertrophic system whose connection to the sea is strongly regulated by a system of sluice-gates. The calibration and validation results presented a significant agreement between the model and the data obtained in several surveys. The accuracy was evaluated using a quantitative analysis, in which the average uncertainty of the model prediction was less than 6%. The results confirmed an expected phytoplankton bloom in April and October, achieving mean maximum values around 250 μg l −1 of chlorophyll-a. A mass balance revealed that the eutrophication process is magnified by the input loads of nutrients, mainly from the sediments, as well as by the limited connection of the lagoon with the sea. This study has shown that the developed model is an efficient tool to manage the eutrophication problem in heavily regulated coastal lagoons.

Dementia caused by Alzheimer's disease commonly affects the adult population with Down's syndrome. This population presents two characteristic clinical features: a semiologic pattern that differs from the typical Alzheimer's disease, and previous intellectual deficits that may confound the clinical diagnosis. There is a clear need to validate specific instruments adapted to Spanish population.To adapt and to validate CAMDEX-DS (Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and Others with Intellectual Disabilities) in Spanish population.146 patients with intellectual disability (mild to moderate) were recruited and assessed with CAMDEX-DS, K-BIT I and DMR tests. Test-retest reliability, inter-rater concordance and validity statistic were performed between CAMDEX-DS and clinical diagnosis. This is an observational, multicenter, cross-sectional and validation study.Test-retest and inter-rater reliability achieved kappa coefficient values of 0.92 and 0.91, respectively. Agreement (kappa index) for CAMDEX-DS on clinical diagnosis compared to other clinical criteria was high: CAMDEX-DS vs DSM-IV (kappa = 0.95; p0,001); CAMDEX-DS vs ICD-10 (kappa = 0.97; p0.001). All item-test correlations ranged between 0,31 and 0,69. Internal reliability-calculated using Chronbach's alpha scored 0.93.The Spanish version of CAMDEX-DS is a valid instrument with high applicability for people with intellectual disability. It shows good psychometric properties. The Cambridge Cognitive Examination for Older Adults with Down's Syndrome (CAMCOG-DS) can set two key points by the level of intellectual disability on the suspicion of cognitive impairment in people with Down's syndrome.Adaptacion y validacion del Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and Others with Intellectual Disabilities (CAMDEX-DS) en poblacion española con discapacidad intelectual.Introduccion. La demencia causada por la enfermedad de Alzheimer afecta comunmente a la poblacion adulta con sindrome de Down. Esta poblacion presenta dos rasgos clinicos caracteristicos: la presencia de demencia con semiologia distinta a la enfermedad de Alzheimer tipica y deficits intelectuales previos que pueden confundir el diagnostico clinico. Existe una evidente necesidad de validar instrumentos especificos en castellano adaptados a esta poblacion. Objetivo. Adaptar y validar el Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and Others with Intellectual Disabilities (CAMDEX-DS) en poblacion española. Pacientes y metodos. Se consideraron 146 pacientes con discapacidad intelectual (leve-moderada). Se realizo un estudio de validacion de tipo observacional, transversal y multicentrico. Se administraron los siguientes tests: CAMDEX-DS, test breve de inteligencia de Kaufman y Dementia Questionnaire for Persons with Mental Retardation. Se calculo la fiabilidad test-retest, la fiabilidad interjueces, la concordancia del CAMDEX-DS para el diagnostico clinico y la validez. Resultados. La fiabilidad test-retest e interjueces obtuvo un coeficiente kappa de 0,92 y 0,91, respectivamente. El indice kappa del CAMDEX-DS para el diagnostico clinico respecto al resto de los criterios clinicos utilizados fue alto: CAMDEX-DS frente a DSM-IV (kappa = 0,95; p0,001); CAMDEX-DS frente a Clasificacion Internacional de Enfermedades, decima revision (kappa = 0,97; p = 0,000). Todas las correlaciones item-test oscilaban entre 0,31 y 0,69. La fiabilidad interna calculada mediante el alfa de Cronbach fue de 0,93. Conclusiones. La version española del CAMDEX-DS es un instrumento valido, de alta aplicabilidad a personas con discapacidad intelectual, que muestra buenas propiedades psicometricas. El Cambridge Cognitive Examination for Older Adults with Down's Syndrome (CAMCOG-DS) permite establecer dos puntos de corte para la sospecha de deterioro cognitivo en el grupo de personas con sindrome de Down en funcion del nivel de discapacidad intelectual previo.